Need for dialysis rising

Sarah Ladik/NNSL photoNurse Crystal Canadien helps haemodialysis patient Paul Smith at H.H. Williams Memorial Hospital on July 5. Smith and four other patients come in three times a week for the process.

An increasing demand for haemodialysis services remains a concern for H.H. Williams Memorial Hospital, according to a report presented at the Hay River Health and Social Services Authority’s annual general meeting on June 26, but there is still room for expansion in the program.

“We are constantly assessing the current and future dialysis needs in the territory,” Sue Cullen, assistant deputy minister of operations with the Department of Health and Social Services, told The Hub. “Whether we expand to serve more people depends on those needs.”

Haemodialysis is the process through which blood is cleaned of excess waste, such as creatine and urea when a patient is in renal failure. Currently, there are three operating units – referred to as ‘drops’ – at the hospital in Hay River. Each drop can do two runs a day, one in the morning and one in the afternoon, for a total potential patient load of six. Right now there are only five patients receiving haemodialysis in Hay River, with another still in assessment. Patients undergo the process three times a week on a Monday-Wednesday-Friday schedule.

“Hay River (health co-ordinators) have monthly meetings with Stanton (Territorial Hospital in Yellowknife) and the Northern Alberta Renal Program as part of a long-term planning initiative,” Cullen said. “We really have our finger on the pulse that way and we can be proactive in finding solutions.”

While one spot is immediately available should the need arise, H.H. Williams Memorial Hospital also has room for two more drops.

Rodger Blake, a registered nurse and the dialysis co-ordinator at the hospital, explained the cost of having two more hook-ups put in when the suite was constructed in 2007 was minimal and the hospital did anticipate the need for expansion. There is potentially room for a total of eight patients on dialysis in Hay River, which would bring it to a level on par with Stanton Territorial Hospital.

“We could easily go to six patients,” Blake said. “Above six means some alterations to the unit and some fine tuning, but it would definitely be possible.”

Although Blake stated the cost of a single drop is approximately $30,000, Cullen said there is another potential solution to increasing capacity at both the Hay River and Yellowknife hospitals by adding Saturday to the schedule of treatment. If that were the case, patients could opt for a Monday-Wednesday-Friday schedule of either mornings or afternoons, or the same for Tuesday-Thursday-Saturday.

“It would in effect double our capacity,” Cullen said. “But it would mean some staffing shifts and changes that have their own complications.”

Cullen explained that nurses need to follow a two-month intensive program before they can perform the process, and that replacing those nurses when they go on vacation or parental leave can be difficult.

“I cannot underscore enough how specialized this program is,” said Cullen. “If we increase capacity, we need to make sure we have the staff to support it.”

Some, however, argue that the service needs to be expanded into other communities besides Hay River and Yellowknife, as patients from smaller communities are forced to choose between travelling for treatment three times a week or moving.

“Often in the North, it’s hard to provide all the services because we have a small population and big distances to cover,” said Gary Viznioski, president of the Hay River Seniors’ Society. “But if the demand is there and we can do it, I think we should.”

Viznioski – himself a retired employee at H.H. Williams Memorial Hospital – believes the support network of a community surrounding patients is key to their health, and that it can be difficult to balance that network against the time and effort of travel or the decision to move.

“From a personal and seniors’ point of view, I think (haemodialysis) is an extremely important service,” he said. “We have an aging population and the demand is going up.”